异常凝血酶原等三项指标联合检测对甲胎蛋白阴性原发性肝癌的诊断价值  

Diagnostic value of combined detection of abnormal prothrombin and other two indicators in AFP-negative primary liver cancer patients

作　　者：徐瀚峰 陈慧娟 杨晖 张迎 张全安 XU Hanfeng;CHEN Huijuan;YANG Hui;ZHANG Ying;ZHANG Quan'an(Department of Oncology,The Second Hospital of Nanjing,Nanjing Hospital Affiliated to Nanjing University of Chinese Medicine,Nanjing,Jiangsu 210003,China;不详)

机构地区：[1]南京中医药大学附属南京医院,南京市第二医院肿瘤科,江苏南京210003 [2]南京医科大学附属江宁医院肿瘤中心,江苏南京211100

出　　处：《中国临床研究》2023年第9期1302-1306,共5页Chinese Journal of Clinical Research

基　　金：江苏省自然科学基金项目(BK20161110)。

摘　　要：目的联合检测异常凝血酶原(DCP)、高尔基体蛋白-73(GP73)以及α-羟丁酸脱氢酶(α-HBDH),评估其单独及联合检测对甲胎蛋白(AFP)阴性原发性肝癌(PHCC)的诊断价值。方法回顾性选取2021年1月至2022年12月在南京市第二医院就诊的AFP阴性PHCC患者88例(肝癌组)、肝炎肝硬化患者84例(肝硬化组)、慢性乙型肝炎患者75例(肝炎组)和健康对照者67例(健康对照组),所有患者均有HBV感染。检测并比较四组对象血清DCP、GP73及α-HBDH水平,绘制受试者操作特征曲线(ROC)分析三项指标单独及联合检测对AFP阴性PHCC的诊断效能。结果肝癌组患者DCP、GP73、α-HBDH水平分别高于肝硬化组、肝炎组及健康对照组(P<0.05)。在AFP阴性PHCC诊断中,联合检测的ROC曲线下面积(AUC)(0.889),分别高于DCP(0.804)、GP73(0.748)和α-HBDH(0.800)各单项检测,差异有统计学意义(Z=3.078、3.350、3.042,P<0.01)。单项检测以DCP的灵敏度(56.82%)、特异度(91.82%)、准确度(79.35%)最高;而联合检测的灵敏度、特异度、准确度更高,分别是92.04%、96.03%、91.09%。结论在AFP阴性PHCC的诊断中,DCP、GP73、α-HBDH均有一定意义,联合检测有助于提高诊断效能。Objective To evaluate the diagnostic value of abnormal prothrombin(des-gamma-carboxy prothrombin,DCP),Golgi protein 73(GP73)andα-hydroxybutyrate dehydrogenase(α-HBDH)in the patients with alpha-fetoprotein(AFP)-negative primary hepatocellular carcinoma(PHCC).Methods A retrospective analysis was conducted on the patients with hepatitis B virus(HBV)infection treated in Second Hospital of Nanjing from January 2021 to December 2022,including 88 PHCC patients with negative AFP(PHCC group),84 patients with hepatitis cirrhosis(cirrhosis group)and 75 patients with chronic hepatitis B(hepatitis group).At the same time,67 healthy persons were served as control group.The serum DCP,GP73 andα-HBDH levels were detected and compared among these groups to assess the diagnostic efficacy of the three indicators(alone or in combination)for AFP-negative PHCC by drawing receiver operating characteristic(ROC)curve.Results The levels of DCP,GP73 andα-HBDH in PHCC group were significantly higher than those in cirrhosis group,hepatitis group and control group(P<0.05),respectively.In the diagnosis of AFP-negative PHCC,the area under ROC(AUC)of combined detection of DCP,GP73 andα-HBDH was 0.889,which was higher than that of DCP(0.804),GP73(0.748)andα-HBDH(0.800)individually,and there were significant differences(Z=3.087,3.350,3.042,P<0.01).The sensitivity(92.04%),specificity(96.03%)and accuracy(91.09%)of combined detection were the highest,followed by those of alone DCP(56.82%,91.82%,79.35%,respectively).Conclusion DCP,GP73 andα-HBDH have certain value in diagnosing AFP-negative PHCC,and the combined detection is helpful to improve the diagnostic efficiency.

关 键 词：原发性肝癌 甲胎蛋白阴性 异常凝血酶原 高尔基蛋白-73 Α-羟丁酸脱氢酶 

分 类 号：R735.7[医药卫生—肿瘤]